Frankel Allan, Grillo Sarah Pratt, Baker Erin Graydon, Huber Camilla Neppl, Abookire Susan, Grenham Marianne, Console Pam, O'Quinn Mary, Thibault George, Gandhi Tejal K
Patient Safety, Partners Healthcare, Boston, USA.
Jt Comm J Qual Patient Saf. 2005 Aug;31(8):423-37. doi: 10.1016/s1553-7250(05)31056-7.
Brigham and Women's Hospital (BWH) began Patient Safety Leadership WalkRounds in January 2001; its experience, along with that of three other Partner Healthcare hospitals, is reported. COLLECTING DATA ON WALKROUNDS: Data were obtained from interviews with patient safety personnel, WalkRounds scribes, and senior leaders.
A total of 233 one-hour WalkRounds during 28 months yielded 1,433 comments--30% related to equipment, 13% to communications, 7% to pharmacy, and 6% to workforce. Actions occurred quickly in small hospitals. Formal processes for managing larger issues were necessary in large organizations. Implementation feasibility featured more prominently than severity in determining actions.
The study generated essential guidelines for success--for example, the supporting resources must include the maintenance of effective information databases that identify actions taken, and the discussions during WalkRounds are influenced by who in leadership is participating, their ability to quietly listen, and whether they have clinical or nonclinical backgrounds.
WalkRounds appears to be an effective tool for engaging leadership, identifying safety issues, and supporting a culture of safety.
布莱根妇女医院(BWH)于2001年1月开始推行患者安全领导巡视;本文报告了该医院以及其他三家合作医疗医院的经验。
数据来自对患者安全人员、巡视记录员和高级领导的访谈。
在28个月内共进行了233次为时一小时的巡视,收集到1433条意见——30%与设备有关,13%与沟通有关,7%与药房有关,6%与员工有关。小医院能迅速采取行动。大型组织需要有处理重大问题的正式流程。在确定行动时,实施可行性比问题严重程度更为突出。
该研究得出了成功的基本准则——例如,支持资源必须包括维护有效的信息数据库以记录所采取的行动,巡视期间的讨论受参与领导的人员、他们安静倾听的能力以及他们是否有临床或非临床背景的影响。
巡视似乎是促使领导层参与、识别安全问题并支持安全文化的有效工具。